Providing compassionate care to kids with severe obesity

Sarah RaatzQ&A with Sarah Raatz, M.D., M.P.H., inaugural pediatric obesity medicine fellow

With Masonic support, the Center for Pediatric Obesity Medicine launched a fellowship program, one of only a handful nationwide, to provide extensive training to pediatricians interested in this emerging specialty. Inaugural fellow Sarah Raatz, M.D., who completed her training in June 2021 and is now part of the U’s pediatrics faculty, reflects on this unique experience.

What brought you to the University of Minnesota? What drew you to pediatric obesity medicine? 

I was initially drawn to the U for my pediatrics residency because they had a very strong global health program and I had family in Minneapolis.

During the course of my residency, my clinical interests shifted as I was exposed to more specialties. I discovered Dr. Claudia Fox and the pediatric weight management clinic, and became very interested in the subspecialty because it checked a lot of boxes for me in everything from endocrinology to GI work. The Center for Pediatric Obesity Medicine (CPOM), which Dr. Fox codirects, is pretty unique. There was nothing like it in Michigan where I went to medical school and I had no idea the subspeciality existed until I was at the University of Minnesota. It was a very new area and I really liked it.

Tell us about your pediatric obesity medicine fellowship experience.

Over the last two years, I worked in the pediatric weight management clinic and I currently have my own patients two days per week. I also completed coursework for a master’s degree in clinical research, and completed clinical electives in areas such as type 2 diabetes, sleep medicine, hyperlipidemia, psychology, adult weight management, and bariatric surgery. The fellowship was a really well-rounded experience. It gave me confidence as a clinician and provided a comprehensive view not only of weight management in our clinic, but of weight management in the broader health care system. 

What was the most rewarding aspect of your fellowship training? 

A lot of our patients come in quite guarded and worried about how their appointment will go. They really struggle with their weight and haven’t had success with healthy eating or lifestyle modifications, or have been subjected to weight bias. 

One of the most rewarding parts of my fellowship was learning how to talk to these patients and their families. It was wonderful to see them relax and feel relieved that we were on their side, and to be able to offer them something they never tried before, whether it was medication or bariatric surgery. I had patients who had never had success until they came to us. It was a very rewarding experience!

It was also rewarding to have my own patients. I am now a pediatrics faculty member at the University of Minnesota, which is especially exciting because I can keep all of my patients, some of whom I’ve followed for almost two years!

It’s been said that the Center for Pediatric Obesity Medicine likes to push the envelope, if you will, when it comes to trying new treatment strategies. What has your experience with this been like? 

For me, it feels very normal and appropriate to consider medication or surgery for weight management, especially for kids with severe obesity. But if you talk to someone from another program, this might be very different from what they’re used to. It’s always interesting to go to conferences and be reminded of how novel our work is here at the U. You get people who are seeing kids for weight management elsewhere, but are still solely focused on lifestyle modification therapy. It makes you realize how advanced we are and how much we’re taking things in a new direction, but one that’s necessary to provide good care to patients. 

How has the pandemic impacted your work at the clinic? 

Because we’re a fairly unique clinic and a subspecialty that doesn’t exist everywhere, we have a lot of patients who travel from far away to see us. Now we’re able to offer virtual visits and it’s a lot easier, especially if we have a patient who just needs a quick check-in and can get by without a face-to-face visit.

But it’s also been a difficult year in general for the mental health of most kids and adolescents. For our patient population, these mental health concerns can affect their eating and weight status. When you combine this with social distancing, eating out of boredom, financial strain, cancelled sports and extracurricular activities, and other stressors of the pandemic, it’s easy to see how this has been an incredibly challenging time for our patients. The pandemic has influenced many components of weight management and lifestyle modification therapy, making it ten times harder than it was to begin with. 

What does it mean to you to know you’ve been supported by Minnesota Masonic Charities? 

Pediatric obesity medicine is such an interesting field because we know that obesity is so prevalent. Around one in five kids have obesity, and it affects so many aspects of their health, and increases their risk of long-term health complications such as type 2 diabetes, premature cardiovascular disease, liver disease, and more. Yet there isn’t a lot of training available for medical students or residents. The fact that there’s a lot of investment at the U is very special. 

All of us at the Center for Pediatric Obesity Medicine know this is important work, but it is really special to have such generous donor support. It keeps us moving forward even if there are roadblocks along the way. Obesity is often undermined as a chronic condition and isn’t getting the amount of attention it should when it comes to training physicians in obesity medicine, so getting this support has been excellent!

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